CT scan of the pelvis, combination study at Holy Name

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

AMGEN CT PELVIS W/ & W/O

Teaneck, NJ

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How this price compares nationally

Holy Name’s median price of $704 is 44% above the median hospital's median price ($487), higher than 60% of the 2,552 hospitals reporting CPT 72194. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 72194 at Holy Name

Negotiated rates from the hospital’s own file: 9 payers, 21 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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#
1	Aetna medicare prime facility · fee schedule · outpatient	$189	$189	—	—	—	$189 – $189
2	Aetna golden medicare facility · fee schedule · outpatient	$210	$210	—	—	—	$210 – $210
3	Clover clover facility · fee schedule · outpatient	$210	$210	—	—	—	$210 – $210
4	UnitedHealthcare medicare facility · fee schedule · outpatient	$210	$210	—	—	—	$210 – $210
5	WellCare medicare facility · fee schedule · outpatient	$212	$212	—	—	—	$212 – $212
6	UnitedHealthcare medicaid facility · percent of total billed charges · outpatientfrom % of charges	$337	$356	$66	18%	—	$287 – $445
7	Aetna better health mcd/chip facility · percent of total billed charges · outpatientfrom % of charges	$354	$374	$69	18%	—	$302 – $467
8	Aetna qualified health plans facility · percent of total billed charges · outpatientfrom % of charges	$405	$429	$79	18%	—	$346 – $535
9	UnitedHealthcare uhc facility · other · outpatient	$543	$543	—	—	—	$543 – $543
10	Ambetter ambetter facility · percent of total billed charges · outpatientfrom % of charges	$527	$558	$103	18%	—	$450 – $697
11	Aetna whole health facility · fee schedule · outpatient	$575	$575	—	—	—	$575 – $575
12	Cigna hmo/pos facility · fee schedule · outpatient	$609	$609	—	—	—	$609 – $609
13	Aetna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges	$711	$752	$139	18%	—	$607 – $939
14	First Health first health facility · percent of total billed charges · outpatientfrom % of charges	$1.0k	$1.1k	$197	18%	—	$860 – $1.3k
15	Aetna worker's comp facility · percent of total billed charges · outpatientfrom % of charges	$1.3k	$1.4k	$251	18%	—	$1.1k – $1.7k
16	MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges	$1.4k	$1.5k	$268	18%	—	$1.2k – $1.8k
17	MultiPlan worker's comp facility · percent of total billed charges · outpatientfrom % of charges	$1.8k	$1.9k	$350	18%	—	$1.5k – $2.4k
18	MultiPlan auto accident medical facility · percent of total billed charges · outpatientfrom % of charges	$1.9k	$2.0k	$371	18%	—	$1.6k – $2.5k
19	Blue Cross Blue Shield indemnity facility · percent of total billed charges · outpatientfrom % of charges	$2.0k	$2.1k	$382	18%	—	$1.7k – $2.6k
20	Blue Cross Blue Shield managed facility · percent of total billed charges · outpatientfrom % of charges	$2.0k	$2.1k	$382	18%	—	$1.7k – $2.6k
21	Blue Cross Blue Shield ppo facility · percent of total billed charges · outpatientfrom % of charges	$2.0k	$2.1k	$382	18%	—	$1.7k – $2.6k

Last updated: Nov 10, 2025

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